Without a shadow of a doubt, caregivers face incredible challenges. One of the many obstacles is navigating Medicare, as staying up to date with all the changes that happen annually is time-consuming.
Below, we’ll explain the changes going on with Medicare in 2020, so you can continue helping the ones you care for with their Medicare coverage.
Medicare Access and CHIP Reauthorization Act (MACRA)
The Medicare Access and CHIP Reauthorization Act changed the payment system that doctors who accept Medicare use to treat patients.
How MACRA Impacted Medicare Beneficiaries Directly
MACRA only impacts those who are considered Medicare eligible after 2020. If you’ve been caring for a beneficiary who’s been eligible for Medicare since before 2020, this won’t impact them.
What MACRA did to newly eligible individuals is it eliminated some of their plan options. The plans discontinued were the ones that covered the Part B deductible, also known as first-dollar coverage plans. These plans include Plan C, Plan F, and high deductible Plan F.
For those not eligible for one of the above plans, that next best option is Plan G. The only benefit Plan G doesn’t cover is the Part B deductible, which is $198 in 2020.
Tip: do not ever pay the Part B deductible at the doctors’ office. They should always bill Medicare. That way, they have on record you met that deductible.
New High Deductible Plan Introduced
In lieu of MACRA, CMS introduced a new high deductible plan, high deductible Plan G. Just like high deductible Plan F, this plan comes with a deductible that must be met before coverage kicks in 100%. That deductible is $2,340 for 2020.
The high deductible versions are a great alternative to the standard plan options. It allows beneficiaries to have the same coverage at a much lower monthly premium.
New Open Enrollment Period Introduced
A new open enrollment period was introduced over the past two years, but word about it didn’t get out until recently. If the beneficiary has a Medicare Advantage plan, and are unhappy with the benefits, you have a new window of opportunity to make changes.
Between January 1st and March 31st, Medicare Advantage beneficiaries can switch to another Advantage plan that’s available in their area, or disenroll from Advantage all together and go back to Original Medicare.
The new enrollment period is called the Medicare Advantage Open Enrollment Period. Previously, it was known as the Medicare Advantage Disenrollment Period.
Part A and B Increases for 2020
For most, Part A is premium free. The Part A deductible is $1,408. The monthly Part B premium is $144.60 for beneficiaries who do not fall in a higher income bracket. As stated above, the Part B deductible is $198.
Medicare Advantage Plans Now Offer Long-Term Care Benefits
Traditionally, Medicare doesn’t cover any long-term care benefits. However, CMS is now allowing carriers to expand Advantage benefits to include long-term care services.
Long-term care can mean many different types of services. In this case, long-term care pertains to “activities of daily living.”
These activities include eating, going to the bathroom, getting dressed, bathing, maintaining continence, and transferring.
Since these benefits are new, you won’t find many Advantage plans that include them yet. We hope to see more Advantage plan options with these benefits included throughout the year.
Don’t Be Misled by Medicare Commercials
We all see it, those commercials that repeat over and over during the Annual Enrollment Period between October 15th and December 7th.
These commercials are very misleading. Beneficiaries need to weigh out all the pros and cons of Advantage plans before enrolling.
These commercials highlight “zero-dollar premiums.” What they don’t tell you is these carriers are able to offer zero to low monthly premiums because they charge copays for every visit and service.
If the one you’re caring for gets sick, they’ll likely end up spending more out of pocket in copays then they would’ve in monthly premiums for a Medigap plan.
Tips for Caregivers Caring for Someone with Medicare
Complete an Authorization to Disclose
Sometimes you may find that you’ll need to call Medicare on behalf of the person you’re caring for. You’ll need to be sure that the beneficiary authorizes you to speak on their behalf and complete an Authorization to Disclose form. This document will permit Medicare to work with you.
New Drug Cost Comparison Tool Launched
Medicare.gov released a new tool to compare drug costs between different plans. You can help the one you’re providing care for by reducing the costs of their prescriptions.
The tool will compare all plans available in your area that cover those specific medications once you input the information. It will compare both Part D plans and Medicare Advantage prescription drug plans.
You’ll be able to see if there’s another plan that offers more coverage for those medications. If so, you’ll get two enrollment windows during the year to make changes to the beneficiary’s prescription coverage.
- Medicare Annual Enrollment Period, which is for all Medicare beneficiaries
- Medicare Advantage Open Enrollment Period, which is for Advantage enrollees only
There also may be a Special Enrollment Period that allows the recipient to make changes to their coverage.
Navigating Medicare as a Caregiver
Being a caregiver is rewarding, but also comes with many challenges. Medicare doesn’t have to be one of those challenges. Knowing where to go to find relevant information is critical. An excellent resource for caregivers to find information regarding Medicare is the CMS newsroom.
Lindsay Engle is a Medicare expert at MedicareFAQ. She loves sharing her expertise and knowledge with those who are looking to learn more about Medicare. Her goal is to make sure Medicare beneficiaries are given the right resources to become educated on all their Medicare options.